4JE-15356-12829

2 vaccinations 7 coded responses 19 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 300 / GA
Registered: 2020-12-31

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-30
Dose 1 — Moderna
2020-12-31
Registered in v-safe
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Survey response — day 7, dose 1
MedDRA: Ear pain, Oropharyngeal pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Sore throat and ear ache · Healthcare visit (other): Telehealth visit scheduled for 1/7/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-13
Survey response — day 14, dose 1
MedDRA: Ear pain, Oropharyngeal pain, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sinus infection , sore throat and ear ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-27
Dose 2 — Moderna
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Vein disorder — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Veins in upper arm very detailed and obvious under my skin. In the shape of a rectangle

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-02-09
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-02-10
Survey response — day 14, dose 2
MedDRA: Cough, Ear pain, Headache, Oropharyngeal pain, Paranasal sinus discomfort — Feeling: Fair

Free text: Ear ache, headache, sinus pressure, slight sore throat and occasional coughing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 21, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: Arm of injection still hurts somewhat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — day 28, dose 2
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair

Free text: Sore arm around elbow.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 35, dose 2
MedDRA: Arthralgia, Pain — Feeling: Good

Free text: Left arm still hurts around the elbow. I notice it most when I extend my arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-27	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 1 — day 7, dose 1

2021-01-06

Systemic reaction (other): Sore throat and ear ache

Healthcare visit (other): Telehealth visit scheduled for 1/7/21

Release 1 — day 14, dose 1

2021-01-13

Symptoms: Sinus infection , sore throat and ear ache

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): Veins in upper arm very detailed and obvious under my skin. In the shape of a rectangle

Release 4 — day 14, dose 2

2021-02-10

Symptoms: Ear ache, headache, sinus pressure, slight sore throat and occasional coughing.

Release 4 — day 21, dose 2

2021-02-17

Symptoms: Arm of injection still hurts somewhat.

Release 4 — day 28, dose 2

2021-02-24

Symptoms: Sore arm around elbow.

Release 5 — day 35, dose 2

2021-03-04

Symptoms: Left arm still hurts around the elbow. I notice it most when I extend my arm.

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Paranasal sinus discomfort	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Vein disorder	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release